Obesity: Chubby little emperors; Why China is under- and over-nourished at the same time

MORE than 2,000 years ago “Huangdi Neijing”, a classic Chinese medical text, identified obesity as a disease caused by eating too much “fatty meats and polished grains”. Until a generation ago such a diet was an extravagance beyond imagination for all but the elite. But the Chinese waistline has since expanded, and at an alarming rate.

More than a quarter of the adult population, or roughly 350m people, is overweight or obese (more than 60m squeeze into the latter camp). That is at least twice as many as are under-nourished. With rising incomes and more diverse diets, Chinese people are consuming much more fatty food and fizzy drinks. Meals now contain more than twice as much oil and meats as in the 1980s.

This is producing a health calamity, both in heart disease (which now accounts for over a third of deaths) and in a less-noticed explosion of diabetes, which is closely linked to obesity. The prevalence of diabetes has grown more than tenfold during the past three decades. According to a recent national survey, 11.6% of Chinese adults are diabetic, a share almost as high as in America, whose obesity rate is much greater.

With a catastrophic famine still in living memory, it is little surprise that Chinese people have developed a taste for foods rich in fats and sugars. Fan Zhihong of the Chinese Nutrition Society says people who lived through the famine of the Great Leap Forward and the food shortages of the Cultural Revolution were keen to stop eating the coarse grains of the “dark old days” and have acquired a taste for refined grains and flour which are accomplices to diabetes. Xiang Hongding, a diabetes doctor at Peking Union Medical College Hospital, says “some felt they’d better eat the good food now before it’s too late.” Nearly one in five Chinese aged 60 years and over is diabetic, twice the national rate.

The Chinese are not actually eating more as they get richer: the average daily intake has dropped a little over the past ten years, from 2,100 calories in 2002 to a little more than 2,000 today. This suggests that a sedentary lifestyle may be hurting people’s health as much as changes in diet. Rapid urbanisation means more people are leaving the fields to work in less strenuous manufacturing jobs. Meanwhile in the cities, walking and biking have been replaced by driving cars and sitting on public transport. Recent surveys show that less than 10% of urban dwellers exercise regularly.

Childhood obesity has grown hugely in richer coastal cities. During summer breaks parents send off their pudgy little emperors to weight-loss camps that have sprung up everywhere. The exam-oriented education system doesn’t help matters either: although schools are required to set aside at least an hour for exercise every day, they routinely cancel gym classes to make room for other courses. In May the Lancet, a medical journal, published a study showing that the obesity rate among Chinese boys is 6.9%, almost twice as high as that among adult men.

Perhaps the most surprising consequence of urbanisation is that obesity is expanding even faster in rural China than in the cities. Households on the fringes of cities are especially vulnerable: with farmland sold for development, many dispossessed farmers now spend their days sitting around and eating fatty meals. In 2012 public-health experts gave a warning that villages around Beijing might soon see their diabetes rates surpass rates in the capital. In the same year a report by the health ministry showed that, from 2005 to 2010, toddlers in rural areas were getting overweight or obese faster than toddlers in cities. Yet under-nutrition was not disappearing. Rural rates of underweight and stunted children were still persistently three to four times higher than among their urban counterparts.

That means the countryside is under-nourished and over-nourished at the same time. One is better than the other. But with spending on diabetes accounting for $25 billion in 2010, or 13% of the bills for health, over-nourishment is still an extravagance China can ill afford.

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About bambooinnovatorKB Kee is the Managing Editor of the Moat Report Asia (www.moatreport.com), a research service focused exclusively on highlighting undervalued wide-moat businesses in Asia; subscribers from North America, Europe, the Oceania and Asia include professional value investors with over $20 billion in asset under management in equities, some of the world’s biggest secretive global hedge fund giants, and savvy private individual investors who are lifelong learners in the art of value investing.
KB has been rooted in the principles of value investing for over a decade as an analyst in Asian capital markets. He was head of research and fund manager at a Singapore-based value investment firm. As a member of the investment committee, he helped the firm’s Asia-focused equity funds significantly outperform the benchmark index. He was previously the portfolio manager for Asia-Pacific equities at Korea’s largest mutual fund company. KB has trained CEOs, entrepreneurs, CFOs, management executives in business strategy, value investing, macroeconomic and industry trends, and detecting accounting frauds in Singapore, HK and China. KB was a faculty (accounting) at SMU teaching accounting courses. KB is currently the Chief Investment Officer at an ASX-listed investment holdings company since September 2015, helping to manage the listed Asian equities investments in the Hidden Champions Fund.
Disclaimer: This article is for discussion purposes only and does not constitute an offer, recommendation or solicitation to buy or sell any investments, securities, futures or options. All articles in the website reflect the personal opinions of the writer.

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